MODOCUROGYN PLLC NPI 1538445812

NPI Information

  • NPI: 1538445812
  • Provider Name: MODOCUROGYN, PLLC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Doing Business As: AZUROGYNECOLOGY & PELVIC HEALTH CENTER
  • CLIA Number: 03D2031112
  • Address: 6632 E. BASELINE RD
    STE 101
    MESA, AZ
    ZIP 85206
  • Phone: (480) 889-2654

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NPI Details

MODOCUROGYN, PLLC is a specialist in Mesa, AZ. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MODOCUROGYN, PLLC NPI is 1538445812. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Azurogynecology & Pelvic Health Center.

The provider's business location address is:

6632 E. BASELINE RD
STE 101
MESA, AZ
ZIP 85206
Phone: (480) 889-2654
Fax: (480) 699-1022

The provider's authorized official is Krisette Michelle Hawn .
The authorized official title is Practice Manager and has the following contact phone number (480) 889-2654.

The CLIA number assigned to this NPI record is 03D2031112 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/31/2011 and was last updated on 3/21/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist35205ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1I52876MEDICARE UPINARIZONA
2663388MEDICAIDARIZONA
32148398MEDICARE UPINARIZONA
4Z143114MEDICARE PINARIZONA
5094866MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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